NPIMap

Organization Active NPI

Southern Regional Medical Corporation

  • Pharmacy
  • Houma, LA
National Provider Identifier
1639517550
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SOUTHERN REGIONAL MEDICAL CORPORATION
Doing business as
Leonard Chabert Med Ctr Out Pt Phcy
Practice address
1978 Industrial Blvd
Houma, LA 70363-7055
Phone
(985) 873-1282
NPI assigned
Jun 13, 2013
Organization subpart
Yes
Parent organization
SOUTHERN REGIONAL MEDICAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Phyllis Peoples
Title
President and Ceo
Phone
(985) 873-4620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

1978 Industrial Blvd
Houma, LA 70363-7055

Mailing address

8166 Main St
Houma, LA 70360-3404
Phone (985) 873-4141

Other identifiers 2

IdentifierTypeStateIssuer
1233382MedicaidLA
1930379OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Leonard Chabert Med Ctr Out Pt Phcy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Regional Medical Corporation4 organizations share this tax ID, including this one
Part of
Southern Regional Medical Corporation

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1639517550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8166 MAIN ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703603404",
            "telephone_number": "985-873-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1978 INDUSTRIAL BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-873-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN REGIONAL MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN REGIONAL MEDICAL CORPORATION",
        "enumeration_date": "2013-06-13",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "PEOPLES",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "985-873-4620"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1233382",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1930379",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leonard Chabert Med Ctr Out Pt Phcy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.